Telerehabilitation for older people using off-the-shelf applications: acceptability and feasibility

Abstract

We investigated the feasibility of providing telerehabilitation in the home as an alternative to conventional ambulatory rehabilitation. Two groups of patients were accepted for telerehabilitation. The first group were community patients who needed rehabilitation, e.g. following a stroke, a fracture or prolonged hospital admission. The second group was from two rural nursing homes where residents were identified with a recent injury, fall or hospitalisation. Telerehabilitation employed a coaching model, with fewer therapist home visits, more feedback and "homework" for the patient. Patients had a tablet computer loaded with a videoconferencing app to connect with therapists and relevant therapeutic apps. Multidisciplinary care was provided for up to 8 weeks. The majority (86%) of eligible patients consented to receive telerehabilitation in their own home (n = 61) or in the country nursing home where they lived (n = 17). Most services were delivered using the 3G and 4G wireless networks with few technical problems. On average participants felt that they had achieved 75% of the goals set at the beginning of the programme. High levels of satisfaction were recorded. There was a 50% reduction in home visits by staff, or 10 visits per patient. Speech therapists were able to double occasions of service and direct patient contact time, whilst halving their travel time. Previous experience with technology and age were not barriers to this method of delivery but did affect recruitment. Telerehabilitation using off-the-shelf technology is feasible for post-acute treatment.

The use of information and communication technology in healthcare to improve participation in everyday life: a scoping review

“…The use of ICT in healthcare has shown great potential in improving the quality of life among senior citizens [10], by facilitating support in independent living for persons with conditions such as stroke and Alzheimer's disease [11,12]. Moreover, ICT has demonstrated potential in improving communication between patients and healthcare providers [13]. Although it is still unclear how telerehabilitation services can most appropriately be rendered, it has been suggested that ICT can add value to current stroke rehabilitation [14,15].…”

‘Well, if the kids can do it, I can do it’: older rehabilitation patients' experiences of telerehabilitation

“…A systematic review of telerehabilitation research found a high level of patient satisfaction with telerehabilitation . Crotty et al . investigated the feasibility of providing home‐based rehabilitation to older people using ‘off‐the‐shelf’ technologies and found that patients and clinicians were generally positive about this form of service delivery, whilst gains could be made in access, frequency and intensity of therapy.…”

“…9 A systematic review of telerehabilitation research found a high level of patient satisfaction with telerehabilitation. 12 Crotty et al 13 investigated the feasibility of providing home-based rehabilitation to older people using 'off-the-shelf' technologies and found that patients and clinicians were generally positive about this form of service delivery, whilst gains could be made in access, frequency and intensity of therapy. There are, however, very few in-depth explorations of patient experiences with home telerehabilitation programmes, with most patientcentred studies focussing on patient satisfaction using quantitative surveys.…”

The Feasibility of a Telehealth Exercise Program Aimed at Increasing Cardiorespiratory Fitness for People After Stroke

“…Delivering exercise programs via telehealth using video-conferencing may provide an alternative way to enable stroke survivors to engage in supervised exercise at home. Telehealth exercise interventions targeting fitness have proved effective and safe in other populations, including cardiac rehabilitation (Clark et al, 2015), chronic obstructive pulmonary disease (Hwang et al, 2015), cystic fibrosis (Cox, Alison, Button, Wilson, & Holland, 2015) and in the elderly (Crotty et al, 2014), and telehealth is emerging as a cost-effective alternative to providing centre-based exercise programs (Maddison et al, 2018;Southard, Southard, & Nuckolls, 2003;Whittaker & Wade, 2014). In stroke, telehealth has been used successfully to monitor vital signs (Bernocchi et al, 2016), motor recovery, depression and higher cortical function (Sarfo, Ulasavets, Opare-Sem, & Ovbiagele, 2018), and to deliver speech pathology (Hill et al, 2006), upper limb physiotherapy (Benvenuti et al, 2014) and rehabilitation exercises (Bernocchi et al, 2016).…”